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Inspection carried out on 24 August 2020

During an inspection looking at part of the service

About the service

Absolute Care – Barrow is a domiciliary care agency providing personal care to people. At the time of the inspection they were providing personal care to 99 people. These people had a range of needs, some people were living with dementia. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

People's experience of using this service and what we found

At the last inspection we found medicines were not managed safely. At this inspection this had improved and the provider was no longer in breach of regulation.

At the last inspection we found that care visits were not always punctual. People reported, and records showed us that this had improved. Staff were recruited safely to ensure they were of good character.

People felt safe using the service. Staff knew who to contact if they were concerned about abuse. Staff were confident that the management team would respond to their concerns but knew how to use whistleblowing procedures if needed.

People’s health and social care needs were clearly documented. This allowed clear guidance for staff to follow. Staff received training to ensure they knew how to meet people’s needs.

There was clear guidance in place for staff, and people reported that staff wore the correct personal protective equipment. This meant people were protected (as much as possible) from potential infection transmission.

The service was using a new electronic system in order to more safely manage the service. This was shown to be effective, as office staff were aware of any concerns quickly. The registered manager had a plan in place to continue to improve the use of this system and use more effective electronic auditing.

The registered manager understood the requirements of their role. Staff and the registered manager had a clear vision to provide good quality care.

At the last inspection we had some concerns about the timeliness of care visits, and the management of medicines. Both of these concerns have now been resolved. The registered manager also had a clear action plan to continue to improve these areas.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was requires improvement (published 20 September 2019).

Why we inspected

This was a planned inspection based on previous inspection risks

At the last inspection we had concerns about the management of medicines and the timeliness of care calls. We identified a breach of regulation 12 (Safe care and treatment). We completed this inspection, to assess if required improvements had been made. We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.

Enforcement and follow up

At the last inspection we identified a breach of Regulation 12 (Safe care and treatment) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We found sufficient improvements had been made at this inspection, so the service was no longer in breach of this regulation.

We will continue to monitor information we receive about the service until we return to visit as per our reinspection programme. If we receive any concerning information we may inspect sooner.

Inspection carried out on 27 August 2019

During a routine inspection

About the service

Absolute Care – Barrow is a domiciliary care agency providing personal care to people. At the time of the inspection they were providing personal care to 130 people with a range of needs, some of whom were living with dementia.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

People’s experience of using this service and what we found

People felt safe whilst receiving care and support from the staff at Absolute Care – Barrow. However, people were not happy with the timings and duration of calls, although calls were being delivered in line with their contracts.

People were supported with their medicines however the recording and management of these did not meet national guidelines.

People were protected from the risk of harm by comprehensive assessments being completed and by staff who understood safeguarding principles.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People were involved in developing and reviewing their plans of care. People were supported by staff who were appropriately trained. People were supported to eat and drink what they had chosen in a safe way.

People thought they were supported by staff who were kind, respectful and patient. People knew how to raise concerns and felt listened to.

People did not know who the manager was and felt the service was more focussed on the staff than the people. There was not a comprehensive quality assurance and monitoring framework in place.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 17 January 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified a breach in relation to the management and recording of medicines at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Inspection carried out on 26 September 2016

During a routine inspection

The inspection visit took place on 26 September 2016 and was announced. We gave the provider 48 hours’ notice because the service is a home care agency and the registered manager is often out of the office supporting staff or providing care. We needed to be sure they would be in.

Absolute Care Agency (Barrow) is a home care agency based in Barrow upon Soar in Leicestershire. It supports people who live in their own homes within a seven mile radius of the office.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Care workers spoke in consistently positive terms about the quality of training they received. They told us their training prepared them for the role and gave them a full and comprehensive understanding of the needs of the people they supported. People who used the service told us they felt staff were very well trained and knowledgeable. The provider had a staff training plan that was linked to the strategic aims and objectives of the service. There was a particular focus on ensuring that care workers were supported to understand medical conditions people lived with and how to support them to best lead their lives. People using the service and their relatives spoke in consistently complimentary and positive terms about the effectiveness of staff.

Staff were supported through supervision and appraisal and they valued the support they received. Several staff obtained further qualifications and progressed to more senior positions in the service or to professional positions in healthcare.

The registered manager understood their responsibilities under the Mental Capacity Act (MCA) 2015. Staff had awareness of the MCA and understood they could provide care and support only if a person consented to it and if the proper safeguards were put in place to protect their rights.

Staff understood the importance of people having healthy diets and eating and drinking appropriate amounts of fluids. When they recognised people had difficulties with swallowing they informed people’s GP so that a referral to a dietician could be considered. They also supported people to access health services when they needed them, carrying out additional routines to help people prepare for hospital appointments. They had training about people's medical conditions and were able to recognise if a person's health deteriorated. When people needed it they took appropriate swift action to support the person to access health services.

People using the service and their relatives told us consistently that they held staff in high regard. The registered manager and care coordinator `matched' staff with people using the service which meant people were supported by staff that naturally empathised with them. Staff were consequently caring and knowledgeable about people’s needs. People were supported by the same staff most of the time.

People were involved in decisions about their care and support. They received the information they needed about the service and about their care and support. Relatives of people using the service told us they were kept informed about things that were important to them. They told us the information was clear and easy to understand.

People told us they were always treated with dignity and respect. The registered manager actively promoted values of compassion and kindness in the service.

People contributed to the assessment of their needs and to reviews of their care plans. Their care plans were centred on their individual needs. People knew how to raise concerns if they felt they had to and they were confident they would be taken seriously by the provider. When people expressed preferences about th